Non-Hodgkin lymphoma (NHL) is a group of blood cancers that includes all types of lymphoma except Hodgkin lymphoma. Lymphomas are cancers that develop from lymphocytes, a type of white blood cell, and they develop within the lymph system. Lymph tissue is in many parts of the body, so non-Hodgkin lymphoma can start in almost any part of your body, usually within the lymph nodes.
Non-Hodgkin Lymphoma Overview and Symptoms
Non-Hodgkin lymphoma is usually classified primarily by the type of white blood cell affected – T cells or B cells. There are more than 60 types of non-Hodgkin lymphoma, including the more common types below.
Types of B-cell Lymphoma
- Diffuse large B-cell lymphoma (DLBCL)
- Follicular lymphoma
- Chronic lymphocytic leukemia (CLL)
- Small lymphocytic lymphoma (SLL)
- Mantle cell lymphoma (MCL)
- Marginal zone lymphomas
- Burkitt lymphoma
- Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia)
- Hairy cell leukemia
- Primary central nervous system (CNS) lymphoma
Types of T-cell Lymphoma
- Precursor T-lymphoblastic lymphoma/leukemia
- Peripheral T-cell lymphomas
- Anaplastic large cell lymphoma (ALCL)
- Cutaneous T-cell lymphomas
Non-Hodgkin lymphoma is one of the most common cancers, accounting for about 4% of all cancers in the United States.
Non-Hodgkin Lymphoma Diagnosis
Non-Hodgkin lymphoma diagnostic tests may include:
- physician evaluation and a physical exam
- diagnostic imaging such as aPET/CT scan. The PET/CT hybrid scanner is a state-of-the-art diagnostic imaging system that provides more precise information and localization for many cancers; and does it quicker than conventional PET imaging.
- biopsy — either a bone marrow biopsy to examine blood cells, or a surgical or CT-guided biopsy to obtain lymph node tissue samples. Usually biopsy procedures are not carried out at the initial visit, but arranged for a later date, once we have gathered your other information and imaging.
Non-Hodgkin Lymphoma Treatment
The specific Non-Hodgkin lymphoma treatment you receive will depend on the sub-type of Hodgkin lymphoma you have, how far it has progressed when your Hodgkin lymphoma treatment starts, how the lymphoma responds to initial treatment, and other factors. It may include:
- Chemotherapy – the use of chemicals, through one or more types of medication, to treat disease. Chemotherapy interferes with cancer cells’ ability to grow. It can be administered intravenously (through an IV), subcutaneously (an injection below the skin), or orally (as a pill to swallow)
- Targeted therapy – the use of medications to target the specific gene mutations present in your non-Hodgkin lymphoma
- Stem cell transplant – also called bone marrow transplant, in this procedure a donor's stem cells are transfused into your blood. The transplanted stem cells go from your blood to your bone marrow. Through this process, the cells that produced the abnormal cells are replaced with healthy cells that produce normal blood cells.
Types of Bone Marrow/Stem Cell Transplants:
- Autologous stem cell transplants, which are stem cells that come from your own bone marrow or blood. Doctors extract stem cells from your blood or bone marrow, place them in frozen storage, and re-infuse them back into your body following high-dose chemotherapy to eliminate blood cancers.
- Allogeneic stem cell and bone marrow transplants, which are stem cells that come from matched related donors (siblings, for example), or from matched unrelated donors or donated umbilical cords. As a recognized site of the National Marrow Donor Program, BIDMC has access to an international registry of more than 5 million possible unrelated donors.
Dedicated Stem Cell Lab
Our stem cell/immunotherapy laboratory is a key component of our bone marrow transplantation service. The stem cell lab:
- Excels in the special and meticulous handling of human cells
- Provides expertise in the collection, storage, and manipulation of bone marrow and stem cell products so they are ready to be transplanted (re-infused) into the patient
Non-Hodgkin Lymphoma Multidisciplinary Conference
In our weekly multidisciplinary conferences, we review all of your information with the full blood cancer treatment team. (Lymphoma is classified as a type of blood cancer.) Our radiologists report on your imaging studies and our hematopathologists (pathologists who specialize in blood diseases) review the results of your biopsy. Hematologists, oncologists and radiation oncologists voice their opinions. Together as a team focused solely on you, we reach agreement on the best treatment options for your particular situation.
Hematologic Malignancies/Bone Marrow Transplant (BMT) ProgramOur world-renown hematologists, oncologists, radiation oncologists, radiologists and hematopathologists provide state-of-the-art diagnosis and management for blood cancers, including ALL.